Patient Demographics, Quality of Life, and Disease Features of Men With Newly Diagnosed Prostate Cancer: Trends in the PSA Era

• Published in: Urology (Ridgewood, N.J.) Vol. 82; no. 1; pp. 60 - 66
• Main Authors: Glass, Allison S, Cowan, Janet E, Fuldeore, Mahesh J, Cooperberg, Matthew R, Carroll, Peter R, Kenfield, Stacey A, Greene, Kirsten L
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2013; Elsevier
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - diagnosis; Age Factors; Aged; Biological and medical sciences; Biopsy, Needle - trends; Bone and Bones - diagnostic imaging; Chi-Square Distribution; Gynecology. Andrology. Obstetrics; Humans; Male; Male genital diseases; Medical sciences; Middle Aged; Neoplasm Grading - trends; Nephrology. Urinary tract diseases; Prostate-Specific Antigen - blood; Prostatic Neoplasms - complications; Prostatic Neoplasms - diagnosis; Quality of Life; Radionuclide Imaging - trends; Registries; Sexual Dysfunction, Physiological - etiology; Tomography, X-Ray Computed - trends; Tumors; Tumors of the urinary system; United States; Urinary tract. Prostate gland; Urination Disorders - etiology; Urology; Human; Nephrology; Urinary system disease; Prostate disease; Disease; Trend; Male; Early stage; Tumoral marker; Malignant tumor; Urology; Quality of life; Prostate specific antigen; Adult; Male genital diseases; Prostate cancer; Cancer
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2013.01.072

Objective To describe how demographic and diagnostic characteristics of men with prostate cancer in the United States have changed since 1999, using data from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry. Methods The medical records of patients enrolled in CaPSURE between 1999 and 2011 were evaluated. Baseline demographics, disease features, and imaging use were assessed. Mantel-Haenszel chi-square was used to test for trends across diagnostic years. Results Between 1999 and 2011, a total of 9572 patients were diagnosed with prostate cancer and enrolled in CaPSURE at community (36), academic (3), and Veteran's Affairs (4) hospitals. Over the study period, mean age at diagnosis decreased, P  <.01. In 2008-2011, a significant increase in diagnostic Gleason 7 or higher was observed relative to 1999-2001 (50% vs 36%, P  <.01), congruent with recent guideline modifications of the Gleason classification system. An increase in the mean number of diagnostic biopsy cores (13.3 vs 8.3, P  <.01) was also observed. A significant decrease in use of any imaging modality was seen (19% vs 45%, P  <.01). Average pretreatment urinary and bowel function scores did not change, although there were significant increases in sexual function observed overall ( P  <.01). Conclusion In the United States, several trends in the demographics and disease profile of men with newly diagnosed prostate cancer were observed over the past 12 years. Decreased imaging use and increased number of cores taken during diagnostic biopsy are in line with national urologic guidelines on prostate cancer diagnosis and management.